Most practices that are underperforming are not understaffed. They are under-optimized. The tools on this page will show you exactly where — and what it is costing you every month you wait.
When production is down, the instinct is to hire. More people on the phones, one more hygienist, a treatment coordinator to close cases the front office is losing. It feels decisive. It is often expensive.
The real cost of a misaligned hire runs $35,000–$100,000 when you account for salary during the ramp-up period, the time invested in training, the production lost while the seat is open, and then again when the wrong person leaves. Most dental practices absorb that cost more than once in their first decade.
What the numbers rarely reveal is that the condition prompting the hire — low production, missed calls, unclosed treatment — usually has nothing to do with headcount. A front office team converting 40% of new-patient inquiries instead of 70% is not an understaffing problem. It is a systems and language problem. The same team, with different call scripts and a tighter inquiry-to-appointment process, often doubles throughput without a single new salary.
Before your next hire, spend 15 minutes with the tools below. If the gaps are as large as we typically find them, the return on fixing the process will dwarf the cost of adding a salary line. If the gaps are small, the assessment will identify exactly which of the twelve improvement categories to prioritize first.
“Nine out of ten practices I assess are not underproducing because they need more people. They are underproducing because they do not have the systems to fully utilize the people they already have.”Tammy Duncan — Practice Management Systems®
The A.L.I.G.N.™ framework was built from 38 years of coaching dental practices across the country. Every dollar left on the table traces back to one of these twelve areas. The self-diagnosis tools on this page are structured around this same framework.
Fifty questions. Five to ten minutes. You will know exactly which category to prioritize first — and what it is costing you each month to wait.
Both tools are free and available immediately inside the portal. A quick account setup gets you access — no sales call, no commitment required.
Enter your provider count, days per week, and current annual production. The calculator benchmarks your team against Tammy’s 38-year averages and quantifies the annual revenue gap in plain numbers you can act on.
Open the Calculator Free portal account required — sign in or create one hereFifty questions across all five A.L.I.G.N.™ categories. Surfaces which of the twelve improvement areas are your highest-leverage targets and which to tackle first for the fastest measurable result.
Take the Assessment Free portal account required — sign in or create one hereThe pattern we see most often is not a practice that needed Tammy to fix everything from day one. It is a practice that used the calculator to find the scheduling gap, used the assessment to identify front-office call conversion as the next biggest leak, made both changes with their existing team — and emerged with a $40,000–$80,000 annual production increase and enough confidence to tackle the harder work.
When those practices bring us in after that first wave of self-improvements, the coaching engagement changes entirely. We are not rebuilding the fundamentals. We are working on case acceptance language that closes $8,000 crowns, fee schedule analysis that adds 6–9% to collections without adding a single new patient, and leadership development that makes the doctor’s management time more productive and less exhausting.
Implementing the easy wins first is not a workaround. It is the right sequence. The practices that do it arrive at the coaching engagement with a stronger foundation, a more engaged team, and a clearer sense of exactly which problems need outside help. The result is faster improvement across all twelve categories than either path would achieve alone.
The tools below are where that begins. They are free. They are calibrated to 38 years of Tammy’s benchmarks. And if the gaps they surface point to a problem bigger than the tools can address alone — we would like to talk.
“The calculator showed us we were leaving $90,000 on the table before Tammy even walked in the door. We fixed the scheduling and phone process ourselves. When she came in, we were ready for the real work.”PSys Coaching Client — Pacific Northwest
45 minutes with Tammy. No pitch. She will tell you honestly what the numbers mean, which category to fix first, and whether coaching is the right next step or something else is.
Schedule Your Free AssessmentOr start with the free self-diagnosis tools above — no commitment required.
The ALIGN Assessment is a 50-question self-diagnostic tool built on the A.L.I.G.N.™ framework Tammy developed over 38 years of coaching dental practices. It walks through all five categories — Alignment, Leadership, Implementation, Growth, and Numbers — and surfaces which areas are costing you the most production.
The assessment is available free inside the portal. It does not replace a coaching engagement; it gives you a clear, prioritized starting point for your own improvement work — and a clear picture of where coaching would accelerate the result.
The calculator uses benchmarks Tammy has calibrated across hundreds of practice coaching engagements over 38 years: $4,200–$9,000 per doctor provider day and $900–$1,200 per hygiene provider day. The midpoints ($6,600 doctor / $1,050 hygiene) represent a well-run practice operating at strong but achievable production levels.
The output is a directional gap estimate, not a precise audit. But it consistently surfaces the scale of opportunity before a single coaching conversation happens — and most practices are surprised by how large the number is.
Small gaps in daily production often mean the highest-leverage opportunity is in case acceptance, collections rate, or fee schedule optimization rather than schedule utilization. If the calculator shows you are already close to benchmark, the ALIGN Assessment will identify which of the twelve areas is your next highest-value target.
Tammy is also happy to review your numbers on the free 45-minute assessment call and tell you honestly whether coaching is the right next step — or whether something else would serve you better right now.
The tools surface the diagnosis. Tammy’s work is the treatment plan and the accountability structure to implement it — in your office, with your actual team, adjusting what people say in real conversations with real patients in real time.
Many clients implement the scheduling and front-office improvements from the self-diagnosis tools entirely on their own and see $40,000–$80,000 annual gains before they engage. When they are ready for the harder improvements — case acceptance language, fee schedule optimization, leadership development — coaching accelerates the result dramatically because the fundamentals are already solid and the team is already moving.